Obesity

Question 1

Define obesity

Answer 1

Chronic adverse condition due to an excess amount of body fat

BMI >30 kg/m2

> 25 overweight
40 morbidly obese
55 super-obese

Question 2

Aetiology of obesity

Answer 2

Caloric intake that is more, over time, greater than the caloric expenditure

Associated with genetic predisposition (70%), behavioural dynamics, hormonal disturbances, cultural influences

Behaviour: large portion size, increasingly sedentary lifestyle, poor dietary habits, eating disorder, mental illness

Hormonal: hypothyroidism, Hypercortisolism, insulinoma

Question 3

Epidemiology of Obesity

Answer 3

26% of adults were obese
25% of >16 in the UK are obese
2/3 Americans are overweight or obese

Question 4

Symptoms of Obesity

Answer 4

Fat gain

+ complications (T2DM, cardiovascular disease, HTN, hyperlipidaemia, GORD< hiatal hernia, asthma, OSA, Stroke, gout, NASH etc.)

Question 5

Signs of Obesity on examination

Answer 5

BMI >30

Greater waist circumference

Question 6

Investigations for obesity

Answer 6

Clinical exam + BMI

ECG: normal

FBC: normal, may show anaemia
Serum transaminases: normal, may be elevated if liver dysfunction
TFTs: normal, may show hypothyroidism

USS abdomen: normal may show evidence of fatty liver

Polysomnography: normal, may show signs of OSA